2102 ROSS AVE 2019-11-14 - Laserfiche WebLink

iiii PERMIT APPLICATIO^" ME BUILDING iJIECHANICAL I PLUMBING /SIGN i EPRINKLER/ DEMOLITION E V E R E T TCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 2 '3 L g 65'S AI'(. PROPERTY TAX#: Z 9C8-096621-30/160 O(321-30YCO LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: ,116.././G, Gamil TENANT BUSINESS NAME(CommercialMCJak 41\73..P OWNER MAILING ADDRESS: STREET / i.Z C'O 2_ Y .o SS PV-_ , CITY c„ � -i «r STATE act / fk ZIP g 1 OWNER PHONE: f 2,-.57-2,-.57- �2.:" '55 2-6 OWNER EMAIL: 1/2, J C- `�E RC 1 din :�Zf`I CONTRACTOR NAME: / i �D V11 l—('ttG COO Ce &' 4' 6CONTRACTOR ADDRESS: STREET ( •W __ L.,0/- Co-f' 'O ff lip,,, �j CITY c'�.0 ( IA STATE to ZIP 9-9' 7 S CONTRACTOR PHONE: "106 93C,) S?Cl- / CONTRACTOR EMAIL: q.t -za j'VVVL��,(=1p mA-U.Cr: Ir/ r 1 �'\' CONTRACTOR LICENSE#(REQUIRED): " 'FG;1 J_�,076 P j7 CITY OF EVERETT BUSINESS LICENSE#(RE UIR PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) 'II CONTACT NAME: CONTACT PHONE: 2_0C-736- S7 9-\ 66c5Y M,V CONTACT EMAIL: /,t'* -LC/ c MA/C.,Cow% BUILDING INFORMATION Existing Use of Building: 50_ter eii_f , FAB Contract Price of Work: $ Oa CfD Proposed Use of Building: '�F�',SLw-Q Heat Source: ❑Gas Wlectric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU OMulti-Family-#Units: Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sig/n ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: s77(� /0 T.-A/VO(/L ZI 7$ %,/#Q(_(.--NtOI,,,C/T'EA Gt.4/'tz,,,$ e /Pilr�7,1f CrOn/S 01 2 4 fee c,/Q-_L,S'. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer /, Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System No.of Heads ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. � City of Everett Official Use Only ✓ / PER 7 6 � P\( \lct oA —ccA l ____=, Owner/Autho'�d Agent signa ure Date (Revised 4/15/2019) ri—A.